Uncorrected Proof Middle East J Rehabil Health Stud. 2022 October; 9(4):e129651. Published online 2022 October 4. doi: 10.5812/mejrh-129651. Research Article The Effect of Child Spacing on Mothers’ Labor Force Participation in Urban Households of Iran Mahdi Shahraki 1, * and Sara Emamgholipour 2 1 Department of Economics, School of Management and Human Sciences, Chabahar Maritime University, Chabahar, Iran 2 Department of Health Management and Economics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran * Corresponding author: Department of Economics, School of Management and Human Sciences, Chabahar Maritime University, Chabahar, Iran. Email: shahraki.mehdi@gmail.com Received 2022 July 06; Revised 2022 September 05; Accepted 2022 September 10. Abstract Background: Short and long birth spacings have negative effects on the health of mothers and children and consequently on the level of mothers’ employment. Objectives: This study aimed to investigate the effect of first and second children spacing on mothers’ labor force participation in Iranian urban households. Methods: This descriptive-analytical cross-sectional study was performed using econometric methods as a probit and probit model with an instrumental variable in Stata version 16 in 2021. The sample size included 8920 urban households in all provinces of Iran, and the data were extracted from the cost and income questionnaire of urban households. Results: The birth spacing of the first and second child had a positive effect equal to 0.16 on the probability of employment of moth- ers in households with 2 children, which was equal to 0.22 for households with 2 or more children. The coefficients of maternal age, having a private home, father’s education, and father’s age on mothers’ employment were -0.02, -0.09, -0.06, and 0.02 in households with 2 children, respectively. Conclusions: Increasing the birth spacing, especially for the first and second child, led to an increase in the probability of the mother’s employment in the labor market. Therefore, optimal birth spacing is recommended, which improves both the health of the mother and the child and does not reduce job opportunities. In this regard, policies to promote optimal birth spacing through raising awareness, the use of contraceptive methods, and the importance of breastfeeding are also proposed. Keywords: Birth Spacing, Employment, Education, Child, Mothers, Family Characteristics 1. Background “Birth spacing” or “birth interval” is defined as the time gap between 2 consecutive births, which is also known as the inter-pregnancy interval (1). The World Health Orga- nization (WHO) recommends an interval between the last live birth and the next pregnancy of at least 24 months (2), a birth spacing of 33 months (3). Short birth spacing, also regarded as rapid repeat pregnancy, increases the risk of adverse outcomes in mothers and infants (4), includ- ing adverse childbirth consequences, preterm birth, infant mortality, and low birth weight (5, 6). In addition, the in- fants will usually experience sustained health complica- tions such as growth problems, asthma, hearing impair- ment, and low vision (7). Short birth spacing is not only a problem in developing countries as it is also seen in devel- oped nations (1). It should be noted that a very long birth spacing also has negative effects on the infant’s health (4, 8, 9). Apart from health outcomes, very short birth spac- ing increases the population growth rate and weakens the stages of development. As a result, it prevents women from becoming productive members of society and limits their contribution to economic development (10). Since short and long birth spacings have negative impacts on mater- nal and child health (4-6, 8, 9), proper birth spacing is an important issue for their health promotion, which can play an important role in the women’s decision to conceive and labor market participation (11). Therefore, it is impor- tant to evaluate birth spacing, its determinants, and its ef- fects on women’s employment. Several cultural, economic, and social factors have been reported as determinants of women’s employment (12, 13), including the women’s education level and in- come, household income, sex ratio, growth domestic pro- duction per capita, unemployment rate, fertility rate, and cyberspace (14-18). In this regard, birth spacing, with Copyright © 2022, Author(s). This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License (http://creativecommons.org/licenses/by-nc/4.0/) which permits copy and redistribute the material just in noncommercial usages, provided the original work is properly cited.